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General NPI Number Information
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NPI Number | 1891070538
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Entity Type | Individual
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Provider Name | JAMES JOSEPH MATZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/13/2011
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Last Update Date | 10/13/2011
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Provider Practice Location Address
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Address Line | 650 E INDIAN SCHOOL RD 644-114
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City | PHOENIX
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State | AZ
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Zip | 85012-1839
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Country | US
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Telephone | 602-277-5551
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Fax |
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Provider Business Mailing Address
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Address Line | 3829 E HEATHERBRAE DR
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City | PHOENIX
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State | AZ
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Zip | 85018-4810
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Country | US
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Telephone | 602-488-8028
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 33304
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License Number State | AZ
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